Wi Dahee, Lee Rachel Y, Kantrowitz-Gordon Ira
Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois, United States of America.
Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, United States of America.
PLoS One. 2025 May 9;20(5):e0322931. doi: 10.1371/journal.pone.0322931. eCollection 2025.
Sleep deficiency is common during pregnancy, with consequences for maternal and fetal health. This pilot study assessed the efficacy, feasibility, and acceptability of a six-week, online, mindfulness-based intervention (OPTIMISM) in pregnant women with sleep deficiency. Participants were randomized to either mindfulness (self-directed learning modules about mindfulness meditation, sleep challenges in pregnancy, and behavioral strategies) or education-only control conditions. Participants completed surveys and wore an actigraph with daily sleep diaries for 8 days at baseline and post-intervention. The primary outcome was sleep quality. Secondary outcomes included actigraphy, sleep-related impairment, sleep disturbance, fatigue, depression, anxiety, postnatal depressive symptoms, well-being, and quality of life. Exploratory outcomes included feasibility, acceptability, self-management, and behavior change. Efficacy was estimated with analysis of covariance, comparing mean post-test scores corrected for baseline. Of the 351 women screened, 163 were eligible, 64 enrolled, and 59 were randomized. 45 participants (OPTIMISM, 23; control, 22) completed post-intervention assessments and were included in the analysis. The mean satisfaction with the OPTIMISM was higher than the control group (OPTIMISM, 4.1; control, 3.8). The mean sleep quality score was significantly improved in the OPTIMISM group compared to that in the control group after adjusting for baseline score (OPTIMISM, 5.4; control, 7.6; p =.008; partial h2 =.157). There were similar improvements in sleep-related impairment, sleep disturbance, fatigue, and depressive symptoms, but no differences in other outcomes. Findings suggest that OPTIMISM improves subjective sleep quality and psychological distress, including fatigue, depression, and anxiety during pregnancy and should be tested in larger trials with longitudinal follow-up. Trial registration: ClinicalTrials.gov, NCT04016428. Registered on 11 July 2019.
睡眠不足在孕期很常见，会对母婴健康产生影响。这项试点研究评估了一项为期六周的、基于正念的在线干预措施（OPTIMISM）对睡眠不足孕妇的疗效、可行性和可接受性。参与者被随机分为正念组（关于正念冥想、孕期睡眠挑战和行为策略的自主学习模块）或仅接受教育的对照组。参与者在基线和干预后完成调查问卷，并佩戴活动记录仪及每日睡眠日记，为期8天。主要结局是睡眠质量。次要结局包括活动记录仪监测结果、与睡眠相关的损害、睡眠障碍、疲劳、抑郁、焦虑、产后抑郁症状、幸福感和生活质量。探索性结局包括可行性、可接受性、自我管理和行为改变。通过协方差分析估计疗效，比较校正基线后的平均测试后分数。在筛查的351名女性中，163名符合条件，64名登记参加，59名被随机分组。45名参与者（OPTIMISM组23名；对照组22名）完成了干预后评估并纳入分析。对OPTIMISM的平均满意度高于对照组（OPTIMISM组为4.1；对照组为3.8）。校正基线分数后，OPTIMISM组的平均睡眠质量得分与对照组相比有显著改善（OPTIMISM组为5.4；对照组为7.6；p = 0.008；偏η² = 0.157）。在与睡眠相关的损害、睡眠障碍、疲劳和抑郁症状方面也有类似改善，但在其他结局方面没有差异。研究结果表明，OPTIMISM可改善孕期的主观睡眠质量和心理困扰，包括疲劳、抑郁和焦虑，应在更大规模的纵向随访试验中进行测试。试验注册：ClinicalTrials.gov，NCT04016428。于2019年7月11日注册。
